1. Postural Reflexes, Landau Reflex,  Babinski Reflex, Hands Grasping / Pulling Reflexes.
Part 2
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2. Babinski Reflex
The toes spread when the outer edge of the plantar surface of the foot is gently stroked from the heel to the toe.
Protective foot-to-body midline motion
Inward rotation is accompanied by the extension of the big toe in the direction of the head and a plantar flexion of the other toes like a fan
Reflex emerges in the first week after birth
Active from birth to 2 years
Integrated in second year of life, but many linger till third year.
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3. Influences on Development
Right Left Motor Coordination System
Prepares infant for standing and walking – moving the feet
To some extent also triggers Pereze Reflex Pattern
Supports Crawling Reflex – coordination
Supports gait patterns from homo- to cross lateral.
Localization of gravity center
Organization of movement dynamics
Connection of the gravity and body-motion centers
Affects hips
Affects jaw position
Most direct influence: gravity, grounding, stability, and balance
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4. When not Integrated
Restriction of freedom of movement coordination of neck, arms, and upper back muscles
In low muscle tone, neck flops forward
Facial expression suspicious, blaming
Tension in anterior neck flexors
Reflex hyperactive – excessive head lifting, proud, scowling face
Binocular vision and binaural hearing
Flat footed and slow, not like walking
Loose ankles that may sprain easily
Adults walk more on inside or outside of their feet
Hypersensitive, hyperactive – more pressure on outsides of feet
When more pressure on insides feet, tendon guard reflex is activated because of Babinski delay – arch flattening
Tendency to walk on toes and rotate hips inward
Important to learn how to crawl efficiently
Thought and movement integration
Perception and thinking
Can also negatively affect speech development
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5. Clinical Observations
Note feet when lying in supine:
Flop outwards
Point to each other
Point rigidly upward
When lying in prone:
Point outwards instead of inwards
Point down and ankles rise off the floor
Ankles either very tense or loose when:
The whole leg is rotated in and out
Rocking the body longitudinally
Check if shoes are worn down from the inside or outside
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6. Babinski Reflex  

7. Assessment
Stroke with thumbnail up along the outer lateral edge of the sole from the heel to the little toe.
Big toe should not lift or the toes fan out of reflex is integrated
Leg should not jerk back (be careful of too light touch eliciting tickle)
Repeat on the other foot.
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8. Intervention Ideas Any type of walk such as bear walk Crawling
Pushing off from wall on scooter board
Kicking heavy suspended ball while in supine
Ball walkouts (pushing off)
Walk barefoot as much as possible
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9. Hands Grasping Reflex (Robinson – MNRI)
Emerges 11th week in utero
Active from birth through first year of life
Protection, support and balance
Gross hand-motor coordination
Fine motor skills
Lateralization
Hand-eye, hand mouth, hand-head turning and hand-leg coordination
Perseverance
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10. When non-integrated Excessive pressure on pencil
Inefficient pencil grasp
Finger fatigue
Aversion to handwriting, written expression, fine motor skills
Negative effect on speech and communication skills.
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11. Hands Grasping Reflex  

12. Assessment
Have client lie on his/her back with arms extended into the air.
Ask them to grasp your first two fingers and look at the position of the fingers, strength, symmetry, etc.
If this reflex is not integrated move to “teach” the reflex by asking the client to grasp various sized objects: fingers, pencil, marker, large tube, etc.
Have them hold for 7 seconds 3-5 times.
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13. Intervention ideas Play dough Theraputty resistance work
Clothespin exercises
Chinese ball manipulation
Translation exercises
Fingers to thumb opposition exercises
Coffee ground palmar hold.
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14. Hands Pulling Reflex (MNRI)
Emerging 12th week in utero
Active from birth to second month
Becomes part of pattern of pulling and flexing arms in attempt to sit or stand up.
Ability to reach for and pull objects into one’s own space
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15. Non-integrated
Poorly regulated muscle tone in arms (always bending, always straight)
Poor fine motor coordination
Aversion to writing
Speech and communication delays
Poor socialization (giving and taking)
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16. Hands Pulling Reflex  

17. Assessment Have the client lie on his/her back.
Ask them to bend his/her arms at the elbow.
Grasp the client at the wrists and ask them to come to a seated position.
Notice whether the client’s head, arms, and abdominals are activated simultaneously, are they all equally strong, are they moving in the appropriate direction, etc.
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18. Sensory Input
Somatosensory (tactile and proprioception) are the main players
Wilbarger brushing protocol with joint compressions
Infant massage
Masgutova Tactile Integration
Other massage techniques including myofacial release
Deep pressure inputs and heavy work
Messy play with various mediums
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19. Informal assessment guide for challenging clients 

20. https://maudeleroux.com/
Maude Le Roux, OTR/L, SIPT, IMC
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